First-Line Helicobacter pylori Eradication in Patients with Chronic Kidney Diseases in Taiwan

Abstract

Aims Patients with chronic kidney disease (CKD) and Helicobacter pylori (H. pylori) infection have a higher incidence of gastroduodenal diseases and therefore are recommended to receive eradication therapies. This study aimed to assess the efficacy of a 7-day standard triple therapy in patients with CKD (eGFR < 60 ml/min/1.73 m2) and to investigate the clinical factors influencing the success of eradication. Methods A total of 758 patients with H. pylori infection receiving a 7-day standard first-line triple therapy between January 1, 2013, and December 31, 2014, were recruited. Patients were divided into two groups: CKD group (N = 130) and non-CKD group (N = 628). Results The eradication rates attained by the CKD and non-CKD groups were 85.4% and 85.7%, respectively, in the per-protocol analysis (p = 0.933). The eradication rate in CKD stage 3 was 84.5% (82/97), in stage 4 was 88.2% (15/17), and in those who received hemodialysis was 87.5% (14/16). There were no significant differences in the various stages of CKD (p = 0.982). The adverse events were similar between the two groups (3.1% versus 4.6%, p = 0.433). Compliance between the two groups was good (100.0% versus 99.8%, p = 0.649). There was no significant clinical factor influencing the H. pylori eradication rate in the non-CKD and CKD groups. Conclusions This study suggests that the H. pylori eradication rate and adverse rate in patients with CKD are comparable to those of non-CKD patients.

Self-reported adverse drug effects and associated factors among H. pylori infected patients on standard triple therapy: Prospective follow up study

“…Following eradication therapy 84.3% of patients reported disease symptom resolution which was a bit lower than reported 91%[57]. Self-reported regimen completion was 94.3% in this study which was comparable with 95.7[58] and a bit lower than 99.8% reported elsewhere[59] and it has no significant influence on self-reported adverse effects. The response of patients showed that 84.3% of patients achieved complete resolution of acid-pepsin disorder symptoms.…”

Helicobacter pylori Eradication Therapy in Patients with Decreased Renal Function: A Systematic Review

“…Liang et al in Taiwan reported a case-control study for 758 patients with H. pylori infection [7]. The eradication regimen was a 7-day standard triple therapy with a proton pump inhibitor (PPI), CAM, and AMPC.…”

“…One study treated cases with normal CCr and was excluded [23]. After scrutiny, five papers were included in this systematic review [4][5][6][7][8] (Figure 1). There were two RCTs and three case-control studies.…”

“…There were four reports of eradication treatment using PPIs, AMPC, and CAM in patients with and without decreased renal function [5][6][7][8] (Table 4). In every study, the eradication rates were similar in patients with and without decreased renal function.…”

“…Reports on eradication in patients with renal dysfunction are accumulating [5][6][7][8]. There is also a review of H. pylori eradication in patients undergoing dialysis [9].…”